Reflections on the Intensive Care Unit

I remember my first experiences in the ICU as a student nurse. I was overcome by the number of machines, cables, tubes and monitors…what did I get myself into? I resolved to push through the ICU rotation and after graduation choose anything but ICU for my nursing career. No way, no how, would I ever understand everything those ICU nurses were able to do. Or so I thought.

Fast forward to today, I’ve spent 32 years of my life in intensive care; first as a nurse and now as a nurse practitioner. What a humbling experience. I have had the honor of caring for people. I remember how frightened and excited I was as a new ICU nurse. I had respectful attention to detail and such empathy for each of my patients and their families. And I began to understand life and death in a very unique way.

Here are a few of my takeaways from these rich years of ICU experience:

  • It takes courage to be an ICU nurse. To stand in the face of pain, uncertainty, distress, chaos, silence, miracles and tragedies and return each day to do it again. To be vulnerable with patients and families and not know all the answers that they so desperately seek is a task like no other.
  • I’ve learned compassion. For my patients, for their families, for my coworkers and colleagues and for myself. We do our best in the midst of distress and act to alleviate it, or at the least, to be there with you through it. A balance of professionalism and humanity.
  • You never know once your head leaves your pillow in the morning if it will come back to rest there at night. To witness the aftermath of a trauma and imagine that this patient was simply living their normal life until THIS happened…for me, it’s life changing. I appreciate simply living my normal life beyond measure. I am grateful for the return of my head to the pillow at night knowing many people will not do this today. The gratitude then spreads like a ripple to the people and events of my life knowing how each moment is to be savored, treasured. Because we never know.
  • Tell them you love them. Many people “know” this one and do it all the time. Many don’t. A distraught son at the bedside of his mother told me his last words to his Mom were shouted in anger. And his Mom wasn’t going to wake again. He wondered if she knew how much he loved her. Remember to tell them. Back in 2005, I invited my Dad to spend the weekend with me, just the two of us. I made one of his favorite meals, we watched movies together, shared a lot of laughs and also just sat and talked. We reminisced about the many happy memories we had and I told him what I wanted him to know from my heart and asked a few questions I’d always wondered about. And five years later, when he was in a coma for a week before he died, I knew we were good. He knew, I knew, without a doubt.
  • Sometimes people know they are dying. I walked into a patient’s room and asked what she was doing. “I’m writing my obituary.” She said her son, her only relative, lived across the country and if she died tomorrow in surgery, he wouldn’t know what to include in her obituary. I had to admit, this one stopped me in my tracks for a second. She never made it out of the operating room. Sometimes people just know.
  • It’s not easy to say goodbye. When given the chance, take it.

And I thought I was overcome by the machines, cables, tubes and monitors in the ICU. To my surprise, it is the poignant moments that are most overwhelming; they are my lessons for living.

“We do not learn from experience…we learn from reflecting on experience.”
– John Dewey

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